Encounter Data Processing System (EDPS) For Risk Adjustment

Maximize financial growth and compliance with accuracy and efficiency.

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Challenge: Managing Revenue and Risk

Managing the complex and ever-changing Encounter Data Submissions Process to meet CMS Compliance with direct impact to Health Plan’s financials. Growing profitability, streamlining processes, and ensuring regulatory compliance are crucial aspects that require efficient solutions.

Expert Assurance Solution

Solution: Streamlined Encounter Submission Process

HealthAxis Encounter Data Processing System (EDPS) solution transcends mere data submission, transforming into a comprehensive solution that harmonizes intricate data processing, compliance, error correction, and strategic guidance for Health Plans navigating the complex landscape of encounter data submission and management.

EDPS Services Offered Include:

Flexibility in data Inputs from multiple sources

Tailored edit logic to meet mandates set by CMS

Generate CMS compliance 837 5010X12 formatted files

Comprehensive, accurate, and timely encounter submissions

Efficient error review, reconciliation, and resolutions

Extensive reporting for every submission

At its core, EDPS seamlessly receives, transforms and transmits meticulously curated and fully compliant encounter data. This process isn’t confined to submissions alone; response transactions are adeptly assimilated and presented through robust categorization and reporting, ensuring visibility and fluid experience throughout the entire process.

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